“Don’t be a butthead.” “Smoke free is the way to bee.” The “ugly truth.” It may have taken 30 years of campaigning, but high school students in Illinois have largely kicked the habit of smoking traditional cigarettes, according to the Illinois Youth Survey conducted by the University of Illinois. While smoking traditional cigarettes has declined (now at approximately 5% of high school students in the state), vapes – a type of electronic cigarette with chemical cartridges – are the number one tobacco-related product used by adolescents.

The Center for Disease Control and Prevention pegs the number of middle and high school students using e-cigarettes at around 2.5 million nationwide. In Illinois, more than a quarter of high school seniors say they use vaping products, a big jump from prior years.  The data is clear: we’ve succeeded in reducing cigarette usage, but vaping is now the problem.

Part of what is contributing to the problem is that many teens do not see vaping as harmful to their health.  Among Illinois high school seniors, 45% believe that vaping or smoking e-cigarettes poses no risk or only a slight risk of harm.

We know vaping hastens death. Research shows vaping increases inflammation throughout the body, raising the risk for life-threatening health issues such as cardiovascular disease.  Vaping also severely impacts oral health, which is directly related to increased risk for long-term threats of dental decay and cancer and compounds many other health issues.   

E-cigarette use among teens has rightfully caught the attention of the Illinois Department of Public Health which has shared resources to help parents speak with kids about the dangers and consequences of vaping.  

Vapes replaced traditional cigarettes. Now, heated tobacco products, also known as HTPs and heat-not-burn products, are gaining steam among Americans. Like vape pens and other e-cigarettes, HTPs come in flavors and are marketed as lower risk than traditional cigarettes even though serious health risks remain. 

For example, the majority of teenagers report that candy flavors were the reason they first tried an e-cigarette. Perhaps ironic, flavored vapes, such as "tutti frutti" and "cotton candy," increase risk for cavities and other oral disease just like actual candies. Flavor additives double the growth of bacteria in the mouth that cause tooth decay, while also decreasing the hardness of tooth enamel by 27%, limiting natural protection against that bacteria.   

That’s why DentaQuest has worked with America’s Toothfairy to develop and share resources that help parents and teens talk — not argue — about vaping. And e-cigarette use among teens has rightfully caught the attention of the Illinois Department of Public Health, which also shared resources to help parents speak with kids about the dangers and consequences of vaping. As an organization focused on prevention, DentaQuest is passionate about educating families about the risks to everyone’s health, and these resources are an important piece of the puzzle.  

We know COVID-19 has intensified the problem. Though national data indicates teen substance abuse remained the same or declined overall amid the pandemic, the number of kids using nicotine products jumped. Life changes from COVID-19 may have reinforced vaping as the predominant method of nicotine consumption among young people because vape pens are easier to conceal at home than alcohol or traditional cigarettes.    

We can see the impact it on their faces. E-cigarettes contain toxins including formaldehyde, cadmium, nickel and lead that damage the skin. Chemicals in e-cigarettes, like propylene glycol, vegetable glycerin and acetaldehyde, can harm both hard and soft tissue in the mouth, while nicotine reduces blood flow in the mouth, resulting in gum disease and even permanent tooth loss. And HTPs produce nicotine-containing aerosol by heating tobacco, meaning they emit many of the same toxic chemicals present in tobacco smoke. HTP emissions also contain tobacco-specific nitrosamines and aldehydes, which are known to cause cancer, as well as carbon monoxide and acrolein, which are toxic.

Poor oral and overall health in adolescence frequently leads to even worse oral and overall health during adulthood.

We can help by talking about it. Educating youth and empowering them with refusal skills to resist marketing and peer pressure ensures fewer young people are harmed by e-cigarettes. It’s why we must support the national, evidence-based CATCH My Breath school program, which reduces students’ likelihood to experiment with vaping by 45%.

And open conversation with adults outside of school is key to helping teens make healthier decisions for their future. Take the time to educate yourself and then talk about vaping with the teens in your life.

The health of a generation depends on it.

Dr. Jim Thommes has been a clinical provider and longtime benefits administrator, now serving as DentaQuest’s Assistant Vice President of Clinical Management. In addition to his role as dental director for DentaQuest in Illinois, he works on a national level to support holistic care and Preventistry by offering guidance and proposing solutions from within the benefits space.